The influence of smoking, age and stage at diagnosis on the survival after larynx, hypopharynx and oral cavity cancers in E urope: The ARCAGE study
Year: 2018
Type: article
Study design: Observational Study
Abstract: Head and neck cancer (HNC) is a preventable malignancy that continues to cause substantial morbidity and mortality worldwide. Using data from the ARCAGE and Rome studies, we investigated the main predictors of survival after larynx, hypopharynx and oral cavity (OC) cancers. We used the Kaplan-Meier method to estimate overall survival, and Cox proportional models to examine the relationship between survival and sociodemographic and clinical characteristics. 604 larynx, 146 hypopharynx and 460 OC cancer cases were included in this study. Over a median follow-up time of 4.6 years, nearly 50% (n = 586) of patients died. Five-year survival was 65% for larynx, 55% for OC and 35% for hypopharynx cancers. In a multivariable analysis, we observed an increased mortality risk among older (≥71 years) versus younger (≤50 years) patients with larynx/hypopharynx combined (LH) and OC cancers [HR = 1.61, 95% CI 1.09-2.38 (LH) and HR = 2.12, 95% CI 1.35-3.33 (OC)], current versus never smokers [HR = 2.67, 95% CI 1.40-5.08 (LH) and HR = 2.16, 95% CI 1.32-3.54 (OC)] and advanced versus early stage disease at diagnosis [IV versus I, HR = 2.60, 95% CI 1.78-3.79 (LH) and HR = 3.17, 95% CI 2.05-4.89 (OC)]. Survival was not associated with sex, alcohol consumption, education, oral health, p16 expression, presence of HPV infection or body mass index 2 years before cancer diagnosis. Despite advances in diagnosis and therapeutic modalities, survival after HNC remains low in Europe. In addition to the recognized prognostic effect of stage at diagnosis, smoking history and older age at diagnosis are important prognostic indicators for HNC.
Source: International Journal of Cancer
DOI: 10.1002/ijc.31294
Authors: Renata Abrahão, Devasena Anantharaman, Valérie Gaborieau, Behnoush Abedi‐Ardekani, Pagona Lagiou, Areti Lagiou, Wolfgang Ahrens, Ivana Holcatova, Jaroslav Betka, Franco Merletti, Lorenzo Richiardi, Kristina Kjaerheim, Diego Serraino, Jerry Polesel, Lorenzo Simonato, Laia Alemany, Antonio Agudo Trigueros, Tatiana V. Macfarlane, Gary J. Macfarlane, Ariana Znaor, Max Robinson, Cristina Canova, David I. Conway, Sylvia Wright, Claire M. Healy, Mary Toner, Gabriella Cadoni, Stefania Boccia, Tarik Gheit, Massimo Tommasino, Ghislaine Scelo, Paul Brennan
Institutions: Centre international de recherche sur le cancer, Rajiv Gandhi Centre for Biotechnology, National and Kapodistrian University of Athens, University of Bremen, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Charles University, University of Turin, Cancer Registry of Norway, University of Padua, Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, University of Dundee, University of Aberdeen, Ninewells Hospital, Newcastle University, University of Glasgow, Queen Elizabeth University Hospital, Trinity College Dublin, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2790860969